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You pay a premium. The carrier takes the risk.
Fully insured is the traditional model: you pay a fixed monthly premium, and the carrier covers whatever claims come in, good year or bad. It's predictable, and it's the default most companies land in, but that premium is priced off a broad pool, not your specific team.
It depends on whether you're priced fairly, not on the structure itself.
Fully insured makes sense for most companies, especially smaller or newer teams that want predictability over claims volatility. The real question isn't whether to stay fully insured. It's whether your premium reflects your workforce's actual risk, or a pool average that's quietly overcharging you.
Step 1 · Share the basics. A short form and your census.
Step 2 · See your workforce risk. Where your premium is fair, and where it isn't.
Step 3 · Review and choose. Every fully insured option side by side, plus level-funded or self-funded if the numbers favor it. You decide.
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AWM Capital — $156,914 saved in 30 minutes.
Light Labs — A finished renewal turned into $113,115 in savings.
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FAQs
What does fully insured actually mean?
You pay a fixed monthly premium and the carrier takes on the claims risk. Whatever your team spends that year, your premium doesn't change.
Is fully insured the wrong choice?
No. It's the right structure for most companies. The question isn't whether to stay fully insured, it's whether your premium reflects your own team or a pool average.
Why did our premium go up when nobody really used the plan?
Because on a fully insured plan a healthy year gives you no upside. The carrier keeps the difference, and your rate is set against a broad pool rather than your own claims.
How would we know if we're overpaying?
Compare your premium against your Benefits Risk Score and against what the rest of the market would charge for the same coverage.
Should we switch to level-funded?
Possibly. A healthy team of 25 to 100 people usually saves most on a level-funded plan. We price both against your census so it's a comparison, not a hunch.
Does switching mean changing carriers or networks?
Not necessarily. We quote your current carrier alongside everyone else, so keeping the same network is usually available.
If we can't find a better setup than what you've got, we'll tell you on the call.
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